Abstract:
BACKGROUND:In many countries, a majority of stroke patients are not assessed for long-term functional outcome owing to limited resources and time. We investigated whether automatic assessment of the modified Rankin Scale (mRS) based on a mobile phone questionnaire may serve as an alternative to mRS assessments at clinical visits after stroke. METHODS AND RESULTS:We enrolled 62 acute stroke patients admitted to our stroke unit during March to May 2014. Forty-eight patients completed the study. During the stay, patients and/or caregivers were equipped with a mobile phone application in their personal mobile phones. The mobile phone application contained a set of 20 questions, based on the Rankin Focused Assessment, which we previously tested in a pilot study. Three months after inclusion, the mobile phone application automatically prompted the study participants to answer the mRS questionnaire in the mobile phones. Each question or a group of questions in the questionnaire corresponded to a certain mRS score. Using a predefined protocol, the highest mRS score question where the study participant had answered yes was deemed the final mobile mRS score. A few days later, a study personnel performed a clinical visit mRS assessment. The 2 assessments were compared using quadratic weighing κ-statistics. Mean age was 67 years (38% females), and median baseline National Institutes of Health Stroke Scale (NIHSS) score was 5 (interquartile range 2-10.5, range 0-23). Median and mean clinical visit mRS at 3 months was 2 and 2.3, respectively. We found a 62.5% agreement between clinical visit and mobile mRS assessment, weighted kappa 0.89 (95% confidence interval 0.82-0.96), and unweighted kappa 0.53 (95% confidence interval 0.36-0.70). Dichotomized mRS outcome separating functionally independent (mRS score 0-2) from dependent (mRS score 3-5) showed 83% agreement and unweighted kappa of 0.66 (95% confidence interval 0.45-0.87). CONCLUSIONS:Mobile phone-based automatic assessments of mRS performed well in comparison with clinical visit mRS and could be used as an alternative in stroke follow-up.
journal_name
Circ Cardiovasc Qual Outcomesjournal_title
Circulation. Cardiovascular quality and outcomesauthors
Cooray C,Matusevicius M,Wahlgren N,Ahmed Ndoi
10.1161/CIRCOUTCOMES.115.002055subject
Has Abstractpub_date
2015-10-01 00:00:00pages
S125-30issue
6 Suppl 3eissn
1941-7713issn
1941-7705pii
CIRCOUTCOMES.115.002055journal_volume
8pub_type
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